COPD并呼吸衰竭患者行有创机械通气时机的临床研究

Study of the juncture of invasive ventilation in treatment of severe respiratory failure of chronic obstructive pulmonary disease

目的探讨慢性阻塞性肺病致呼吸衰竭患者行有创机械通气治疗的时机对患者的影响。方法24例有创辅助通气病人分为两组:轻症组(13例)和重症组(11例),比较两组通气时间、住ICU时间、总住院日、病死率以及呼吸机相关肺炎的发生率。进行统计学分析。结果轻症组通气时间、住ICU时间、总住院日、病死率同重症组差异有显著性(P<0.05),而呼吸机相关肺炎的发生率无明显差异。结论对于慢支合并急性呼衰的患者,短期内如无创辅助呼吸无明显效果,且患者无有创辅助通气的禁忌证,在加强ICU病房护理的前提下宜早期行有创辅助通气。

[Objective] To study the juncture of invasive ventilation in treatment of severe respiratory failure of chronic obstructive pulmonary disease. [Methods] 24 patients with invasive ventilation in RICU were divided into 2 groups： mild ease group （n =13） and severe ease group （n =11）. ComlSared the duration of MV （h）, days in ICU （d）, days in hospital （d）, mortality in hospital （%） and the incidence of ventilator-associated pneumonia （%）. [Result] Significant difference between the mild case group and severe case group except the incidence of ventilator-associ- ated pneumonia. [Conclusion] Incision of trachea in earlier time maybe better for the patient of respiratory failure of chronic obstructive pulmonary disease if there has no conspicuous effect in short term and no taboo.